title: Relationship between 13C-aminopyrine breath test and the MELD score and its long-term prognostic use in patients with cirrhosis.
abstract: BACKGROUND
  (13)C-Aminopyrine breath test ((13)C-ABT) is a non-invasive, dynamic, quantitative liver function test, and the model for end-stage liver disease (MELD) is a recognised biochemical score used to predict survival in patients with cirrhosis.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the relationship between the (13)C-ABT and MELD score in a cohort of cirrhotic patients and, moreover, to assess the prognostic value of (13)C-ABT results in the same group of patients.
  
  
  METHODS
  Forty-six patients with cirrhosis and without hepatocellular carcinoma who underwent (13)C-ABT and who had at least 1-year follow-up were prospectively included in this study. MELD score was calculated at entry into the study in all patients. End-points of the study were 1-year liver-related death or liver transplantation.
  
  
  RESULTS
  (13)C-ABT %dose/h at 30 min (%dose/h30) results showed significant, inverse correlation with MELD scores (r = -0.414, P = 0.004). During 1-year follow-up nine patients died (19.6 %) and two were transplanted (4.3 %). Median (13)C-ABT %dose/h30 results (3.2 vs. 1.8) were significantly higher in patients who survived as compared to those who died or underwent transplantation (P = 0.04). Receiver operating characteristics curves showed that a (13)C-ABT %dose/h30 cut-off of 2.0 had the best accuracy (c-index = 0.717) in assessing 1-year prognosis.
  
  
  CONCLUSIONS
  We observed a correlation between a flow-independent quantitative liver function test and the MELD score, and found that the (13)C-ABT may accurately provide long-term prognostic information in cirrhotic patients.
authors.affiliation: Gastroenterology Unit, Department of Internal Medicine, University of Genoa, 16132, Genoa, Italy, egiannini@unige.it.
authors.forename: Edoardo G
authors.initials: EG
authors.lastname: Giannini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
mesh_terms: D000632:Aminopyrine / Q000378:metabolism; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D008111:Liver Function Tests / Q000379:methods*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015996:Survival Rate
chemical_list: D002247:Carbon Isotopes; D000632:Aminopyrine